State of World Population 2012 - UNFPA Haiti

children, and healthier women also have moreresources to invest in the well-being of theirchildren (Alderman et al., 2001).Impact on infant and child healthand survivalMany cross-national studies have found apositive relationship between family planningand child survival: users of family planningprogrammes are more likely to experiencelower mortality risks for themselves and theirchildren (Bongaarts, 1987). The relationshipshowever, cannot be interpreted as causal due toconfounding factors such as length and intensityof breastfeeding, prematurity, and as yetunspecified biological, behavioural, environmental,socioeconomic, or health-care effectsthat are known to cause large infant mortalitydifferences between families. A recent studycontrolled for many of these factors, however,and found that increasing birth intervals canreduce neonatal mortality, infant mortality andchild mortality (Rustein, 2005). This study concludedthat birth spacing of three to five yearsalone could prevent up to 46 per cent of infantmortality in developing countries.Evidence from country-specific programmesconfirms this finding. A study from Colombia,for example, illustrates that the local availabilityof clinics and hospital beds and increased familyplanning expenditures per capita are associatedwith lower child mortality as well as lower fertilityacross women in urban areas (Rosenzweigand Schultz, 1982). In the Philippines, the presenceof a family planning programme had directeffects on children’s health (Rosenzweig andWolpin, 1986). Improved access to reproductivehealth, improved spacing of pregnancies, anda reduction in the number of risky pregnanciesin Bangladesh all combined to reduce childmortality and improve child survival (Phillips etal., 1998; Muhuri and Preston, 1991; Muhuri,1995; Muhuri, 1996; Joshi and Schultz, 2007).Similar impact was seen in a programme inNavrongo, Ghana (Binka, Nazzar and Phillips,1995; Pence et al., 2001; Phillips et al., 2006;Pence, Nyarko and Phillips, 2007).Recent research has used anthropometricmeasures of lifetime health as a measure ofearly-childhood health. An individual’s heightis a particularly interesting example of this.Adult height is considered as a latent indicatorof early nutrition and lifetime health status:children with low birth-weights, for example,achieve lower heights even if they receive additionalnutrition in childhood. Though height isdetermined by genetic makeup, it is realized inpart through satisfactory nutrition and healthrelatedcare and conditions, particularly in earlytAt a family planningworkshop in Costa Rica.©UNFPA/Alvaro MongeTHE STATE OF WORLD POPULATION 201277